Septic_InformationPermit

Document Sample
Septic_InformationPermit Powered By Docstoc
					                  Madison County Rural Development
                         101 W. Main Rm 202, Madisonville, Texas 77864
                             Tel:(936)349-6148 Fax:(936)348-6614

DESIGNATED REPRESENTATIVE – Don Grooms

INSTALLER I – May install conventional system and ET beds.

INSTALLER II – May install conventional systems, aerobic systems, ET beds, etc.

REGISTERED SANITARIAN (RS) – Evaluates land owner’s topography performs soil
samples and evaluates which system is needed for the type of soil. A RS can also give a plan of
design for ET beds, conventional systems, aerobic systems or any other systems licensed and
approved through TCEQ. This service is charged and set by the RS and is separate from the
permit cost and in some cases the installation cost.

SITE EVALUATOR (SE) - Evaluates land owners topography, performs soil samples and
evaluates which system is needed for the type of soil. A SE can also give a plan of design for ET
beds, conventional systems. This service is charged and set by the SE and is separate from the
permit cost and in some cases the installation cost.

                FOR INSTALLLATION OF YOUR SEPTIC SYSTEM BY A
                            LICENSED INSTALLER:

    1.       Contact either a Site Evaluator (SE) or Registered Sanitarian (RS) and have a site
             evaluation preformed on the property. The site evaluation will let you know what
             type of septic system is needed for your property. The SE or RS will be able to give
             you a plan of design for your system as well.
    2.       Once you know whether you must have a conventional, aerobic or another type of
             system, contact an installer, licensed through Texas Commission on Environmental
             Quality.
    3.       Contact the Designated Representative (DR) and submit the site evaluation and the
             plan of design for approval BEFORE installation begins. This is usually done by the
             licensed installer.
    4.       Contact the permitting office at 101 West Main, Room 115 to obtain a permit to
             construct a new septic system for $210.00. If you will be installing an aerobic system,
             an affidavit will need to be filled out and signed. The land owner should then contact
             the installer and let them know that approval has been given to construct.
    5.       From this point, the installer will keep the DR informed as to the progress of the
             installation. The installer will contact the DR for final inspection.
    6.       Upon final inspection, a notice of approval to operate the On-Site Sewage Facility
             will be issued by the Designated Representative.

                                    ***For Aerobic Systems Only***
Per TCEQ requirements under Chapter 285.7 of the OSSF Rules & Regulatory Guidelines, a two year
maintenance agreement will be included in the installation of the aerobic system. Also under this
regulation, the land owner must keep a maintenance agreement with a company for the maintenance and up
keep of the system throughout the duration of the system. These guidelines are effective February 4, 1997.
                        Madison County Rural Development
                                                         101 West Main – Rm 202
                                                          Madisonville, TX 77864
                                                   (936)349-6148     Fax (936)348-6614
                                                    Don.grooms@madisoncountytx.org


                       APPLICATION FOR ON-SITE SEWAGE FACILITY
                                 NEW CONSTRUCTION
                                   TCEQ REGION #9

NAME OF APPLICANT: __________________________________                                    PHONE: ___________________
MAILING ADDRESS: ______________________________________ CITY & ZIP: _________________
911 ADDRESS (IF DIFFERENT):____________________________________
LEGAL DESCRIPTION: SEC____________ BLOCK____________ LOT___________ DATE_________
COPY OF SURVEY ATTACHED-( ) YES ( ) NO                                       SUBDIVISION: _______________________
OTHER THAN SUBDIVISION: ACREAGE_________________                                      SURVEY___________________
TYPE OF RESIDENCE: ( ) STRUCTURE ( ) MANUFACTURED HOME
SOURCE OF WATER: ( ) PRIVATE WELL ( ) PUBLIC WATER SUPPLY____________________
SINGLE FAMILY RESIDENCE: # OF BEDROOMS__________ BATHS_________ SQ.FT.__________
ESTIMATED USAGE – GALLONS OF WATER PER DAY______________
COMMERCIAL/INSTITUTIONAL (INCLUDING MULTI-FAMILY RESIDENCES) TYPE: ______________
#OF EMPLOYEES/OCCUPANTS/UNITS:____________ DAYS OCCUPIED PER WEEK:__________
SITE EVALUATOR: ___________________________ CERTIFICATION#:________________
DESIGNER: __________________________________ LICENSE# (PE OR RS):________________
PHONE NUMBER: ___________________________
INSTALLER: _________________________________ REGISTRATION #:___________________
PHONE NUMBER: ___________________________

I certify that the above statements are true and correct to the best of my knowledge. Authorization is hereby give to the TEXAS
COMMISSION on ENVIRONMENTAL QUALITY DESIGNATED REPRESENTATIVE (DR) to enter upon the above
described property for the purpose of lot evaluation and inspection of the on-site sewage facility and that a permit to operate the
facility will be granted following successful inspection of the installed system which indicates that the system was installed in
compliance with the commission’s On-Site Facility Rules, TAC30, Chapter 285.


              _________________________________________                                    __________________
                       (Signature of HOME OWNER ONLY)                                                 (Date)

FEE RECEIPT NUMBER__________________________
Applicant Information:                            Site Evaluator Information:

Name:                                             Name:                           _    __
Address:                                          Company:                               _
City:                                             Address:                             _
State:          Zip Code:                         City:           State:      _
Phone:          Fax:                              Zip Code:                Phone:


Property Location:
Lot:           Block     Subdivision:                     Installer Information:
Address:                                                  Name:                      _
County: Madison Unincorporated Area: Y/N                  Company:                   _
City:          Zip Code:                                  Address:                   _
Additional Information:                                   City:___                  _
                                                          State:         Zip Code:_ _
                                                          Phone:         Fax:      __

                                SCHEMATIC OF LOT OR TRACT

Show:
        -Compass North, adjacent streets, property lines, property dimensions, location of buildings,
        easements, swimming pools, water lines and other structures where known.
        -Location of existing or proposed water wells within 150 feet of property.
        -Indicate slope or provide contour lines from the structure to the farthest location of the proposed
        soil absorption or irrigation area.
        -Location of soil borings or dug pits (show location with respect to a known reference point.)
        -Location of natural, constructed, or proposed drainage ways, (streams, ponds, lakes, rivers, high
        tide o salt water bodies) water impoundment areas, cut or fill bank, sharp slopes and breaks.

Lot Size: _______ Acres
                                            SITE DRAWING




FEATURES OF THE SITE AREA

Presence of 100 year flood zone                                   Yes     No 
Presence of upper water shed                                      Yes     No 
Presence of adjacent ponds, streams, water impoundments           Yes     No 
Existing or proposed water well in nearby area                    Yes     No 
Organized sewage service available to lot or tract                Yes     No 
Date Performed:

Property Location:                                  Proposed Excavation Depth:              _

Name of Site Evaluator:                             Registration Number:                ___

Requirements:
      At least two soil excavations must be performed on the site, at opposite ends of
      the proposed disposal areas. Locations of soil boring or dug pits must be shown
      on the site drawing.

       For subsurface disposal, soil evaluations must be performed to a depth of at least
       tow feet below the proposed excavation depth. For surface disposal, the surface
       horizon must be evaluated.

       Describe each soil horizon and identify any restrictive features on the form.
       Indicate depths where features appear.

Soil Boring Number:



Depth Textural                                Drainage        Restrictive
(Feet) Class   Structure(If applicable) (Mottles/Water Table) Horizon                  Observations
0
1
2
3
4
5



Soil Boring Number:



Depth Textural                                Drainage        Restrictive
(Feet) Class   Structure(If applicable) (Mottles/Water Table) Horizon                  Observations
0
1
2
3
4
5